Provider Demographics
NPI:1922622190
Name:GILDEHAUS, APRIL (MT)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:GILDEHAUS
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HERMANN
Mailing Address - State:MO
Mailing Address - Zip Code:65041-1416
Mailing Address - Country:US
Mailing Address - Phone:573-486-0199
Mailing Address - Fax:
Practice Address - Street 1:1011 MARKET ST
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041-1416
Practice Address - Country:US
Practice Address - Phone:573-486-0199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001030310225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist